Perspectives of frontline healthcare workers on telemedicine implementation in hard-to-reach areas of Rajasthan: A longitudinal study

A BSTRACT Context: Telemedicine can reduce healthcare burden in hard-to-reach areas by providing teleconsultations and e-prescriptions. Understanding frontline healthcare workers’ (FLHWs) experiences is essential for evaluating implementation and informing scalable strategies. Aims: To explore FLHWs’ experiences, perceived benefits, and challenges in delivering telemedicine services in Balotra district, Rajasthan. Settings and Design: Five villages in Balotra district, Rajasthan, were included in a longitudinal study involving seven FLHWs (two doctors, five nurses) actively providing telemedicine services. Methods and Materials: Over 10 months (November 2024 to September 2025), FLHWs completed monthly structured Google Forms. Nurses answered six open- and six closed-ended questions; doctors answered seven open-ended and six closed-ended questions. Data captured experiences, benefits, challenges, and suggestions for improvement. Statistical Analysis Used: Closed-ended responses were analyzed descriptively using frequency percentages. Open-ended responses underwent thematic analysis, with code contribution calculated for each theme. Results: Nurses initially rated experiences as “Good” (100%), with 60% upgrading to “Very Good” or “Excellent” by Month 6. Benefits included doorstep care (up to 80%) and reduced patient travel/costs (60%). Doctors highlighted improved access, continuity, and efficiency (80–100%). Key challenges included network disruptions (80–100%) and female patient hesitancy (40% of nurses), with limitations of physical examinations and patient data management (50%). Both groups emphasized the need for reliable portals, stronger connectivity, gender-sensitive staffing, and expanded diagnostic tools. Conclusions: FLHWs perceived telemedicine as a promising approach to improving access, reducing travel and cost burdens, and supporting continuity of care. Sustained implementation requires strengthened infrastructure and integration with existing health systems.